In this 2013 presentation, Dr. William M. Hang (Bill Hang) assembles a roster of leading sleep‑medicine and TMJ experts—John Remmers, David Gozal, Steve Olmos, Brendan Stack Jr., and James O’Brien—to illustrate how pervasive, under‑diagnosed obstructive sleep apnea (OSA) is across the population. He cites striking prevalence figures (65‑80 % of stroke patients, 17 % of U.S. adults, 95 % undiagnosed) and links OSA to serious systemic conditions such as stroke, hypertension, and pediatric cognitive deficits (including a 10‑point IQ drop and a 60‑fold increase in OSA among poorly performing first‑graders). Hang then connects OSA to dental manifestations—tooth wear, erosion, and gastro‑esophageal reflux—arguing that many dentists overlook these clues in favor of cosmetic solutions like Lumineers or braces. He urges dental and craniofacial professionals to adopt a screening mindset, asking patients about snoring, gasping, and sleep quality before proposing aesthetic treatments. The talk culminates in a call for the dental community to become proactive “sleep‑screening” advocates, leveraging the expert consensus to improve patient health outcomes.
Chapters
Here are some experts from the arena of sleep and TMD, and I view these as people who are very well known in their profession. Let's first of all look at John Remmers, who lives in Sedona, Arizona now, and he's retired, a Harvard-trained physician. Who says sleep apnea will be the most common chronic disease in all industrialized countries? Now, John Remmers owns patents on a number of things related to CPAP machines and and breathing for patients who have sleep apnea. He further states that 65 to 80 percent of stroke patients have sleep apnea. That's a pretty compelling fact and figure. 17 percent of the U.S. population suffers from OSA. Now, I know none of you have any problems that way, and none of your family or friends, but it's out there. In reality, everyone in every family knows somebody who snores and probably has sleep apnea. It's that common. 95% of us are undiagnosed, which is pretty scary. That includes long-distance truck drivers. A lot of them. David Gozal, who's been around, trained in Israel, He's, I think, currently living and teaching in Chicago. Snoring's not normal, and snoring should never occur. Wow, that's a pretty strong statement, isn't it? 7 to 13% of all preschool children snore. Sleep apnea is present in 2 to 3% of those kids. It may be responsible for a 10-point drop in IQ, and I suspect someday it's gonna be found to be a whole lot more than that. And, I mean, it's really pretty compelling to think about. A lot of the kids that enter first grade are never going to do well. And no matter how much they're going to do, they're just— they're not okay anymore. And if you don't address the problem in children, you may never be able to reverse the cardiovascular problems which will occur. So now you begin to understand just how important this really is. And in a 1998 study of the In a group of 297 poorly performing first graders, the incidence of OSA was 60 times more frequent than in a normal group. Steve Olmos from down in San Diego, 90% of OSA patients suffer from hypertension. 40% of us over age 40 snore. Now, I'm not over 40, so I don't know, but, you know, I understand that happens. Brendan Stack Jr., 60 to 80% of snorers test positive So of that 40%, 60 to 80 of those test positive. He's an ENT in Arkansas, and his dad is one of the most world-famous TMJ doctors in the world. This is what really gets me. 20% reduction in your ride here on planet Earth. That's pretty compelling, so you better get— wanna get with the program. Becomes very important. That is not his picture. I'm sorry, Byron, but we don't have his picture. That's just a blank in here. But here's something that you know about all the time. You see these patients, they come in, oh, they've got worn teeth. And so how many dentists in the United States are gonna look at the worn teeth, and let's be really, really honest about our profession, how many are then going to diagnose that patient with an acute lack of lumineers? I hate to be cynical, but it happens all the time. Rather than, Mrs. Jones, it would appear to me that your teeth are somewhat worn. I'm concerned about that. Do you happen to snore? Well, yeah, I do. My husband or my significant other says that I do. Do you have any reason to believe that you stop breathing at night? Well, yeah, my husband says that I do gasp a little bit. Or usually it's the other way. It's a man and the woman says that. Do you wake up, do you wake up well-rested? No, I feel horrible in the morning. These are the questions that should be asked rather than, gee, we've got these new Lumineers, we can give you a new smile. Would you like— why don't you sit down, we have some time, we'll do it right now. That's essentially the way orthodontics is sold in the United States. Oh, by the way, you have crooked teeth. Oh, oh, we happen to have some time. Would you like braces? That's the way you're supposed to sell orthodontics. Now, we don't do that because we don't want to sell anything. But the point is, you're seeing this all the time. The first thing you think about is wear. And of course, along with wear, you have erosion of the teeth, gastroesophageal reflux disease, which is related to the OSA as well. So when the teeth are dissolving away before your very eyes, there's a reason for that too. But how many, how many throwaway journals do you see that show you how to put Lumineers or veneers or whatever on worn teeth and they never mention sleep apnea? I look at this stuff all the time and I have it in other lectures. I have some of these articles that show you that. And this is one of the more compelling ones that I have. James O'Brien is a physician speaking In New Orleans, a year and a half ago, at the American Academy of Craniofacial Pain meeting in New Orleans, at 1:15 in the afternoon, I wrote it down, from Waltham, Massachusetts, 4 sleep clinics throughout the Boston area. Everyone who snores will develop sleep apnea if they live long enough. Thank you.
